NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

Walden University NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

Whether one passes or fails an academic assignment such as the Walden University NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

The introduction for the Walden University NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

After the introduction, move into the main part of the NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8114 Module 4: INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

Critical Assessment

Medical personnel play a key role in ensuring that patients get the best treatment and disease management services available. Therefore, it is their ethical, moral, and professional obligation and responsibility to ensure that the services they offer meet the expected standards of care. In addition, such services need to meet patients’ needs and lead to patient satisfaction. Therefore there is always a need to ensure that these medical personnel are well trained and on a frequent basis to focus better on various aspects of care and improve care outcomes (Xu & Wenhu, 2021). The training is also key to preparing medical personnel for interdisciplinary care, as disciplinary care has been shown to effectively improve patient outcomes. The need for training the medical personnel may mean that a practice change is undertaken. Therefore, the purpose of this assignment is to formulate a critical assessment of the search outcomes that synthesizes the evidence from the literature review performed.

The Research Question and The Search Conducted

It was important to formulate a research question to guide the literature search and analysis. Therefore, the research question formulated was: Can the medical personnel be trained to effectively facilitate interdisciplinary care, resulting in exceptional patient-centered care and fewer emergency room or hospital readmissions? In an effort to answer this research question and explore suitable evidence that can inform practice change, a comprehensive literature search was conducted. Various databases were instrumental in obtaining the relevant articles. They include google scholar, the Cochrane Database of Systematic Reviews, Ovid, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Medline. Suitable keywords were used to retrieve the articles, and only articles published in the last five years were included for synthesis.

Critical Assessment of Search Outcomes

Critical assessment and evidence synthesis is a comprehensive process that can be used to guide the project implementers into finding the best evidence, which can then be used to introduce a practice change. One of the things which informed the formulation of the research question is the need to offer exceptional patient-centered care, fewer emergency room visits, and hospital readmissions. It is important to note that various problems were noticed at the practice site, such as increased rates of emergency room use or visit and higher incidences of hospital readmissions which lead to other undesirable problems among the patient population. Therefore, the literature search for relevant evidence yielded several articles, which were reviewed in the literature review part.

 According to Fortin et al.(2021), training of medical personnel led to improved patient outcomes. The researchers engaged in training various medical personnel, such as nurses, nutritionists, and kinesiologists, to offer specific patient care to patients through interdisciplinary care for multimorbidity. Through their efforts, the patients were able to increasingly engage in health behaviors such as the use of appropriate nutrition and engaging in physical exercise.

The focus of this research was also similar to the report by Uslu-Sahan et al. (2020), which also focused on the interprofessional aspects of care. This study entailed an exploration of the impact of interprofessional simulation-based training in gynecologic oncology palliative care.  Such interprofessional simulation-based training led to the participants acquiring improved teamwork attitudes, interdisciplinary perception, and palliative care knowledge, which are considered as important to improved patient-centered care and other patient outcomes. Therefore, these two studies show the importance of training medical personnel to offer effective patient care.

Another source of evidence for the practice change was provided by the article published by Jeon et al.(2020). This study was conducted with the major aim of assessing the effectiveness and feasibility of an interdisciplinary home-based program that integrates various evidence-based strategies and cognitive rehabilitation strategies for dementia intervention. The strategies were used by various medical personnel, such as psychologists, occupational therapists, and registered nurses.

 The efforts made by these professionals led to notable improvements. For example, the patients showed improved functional dependence as well as physical functioning. Therefore, similar to the work reported by Fortin et al.(2021), this source also entails an interdisciplinary approach where various professionals were trained to offer the intervention. It is worth noting that this intervention also led to various improvements, which further underlined the suitability of this evidence as well the possibility of using the findings to inform practice change.

The report by Liu et al.(2023) also focused on improving outcomes among the geriatric population. The researchers focused on using a multidisciplinary treatment approach led by nurses. The team was offered adequate training to help focus on offering care that would help reduce the rates of unplanned readmission among this group of patients and improve independence in activities of daily living. Therefore this is another source that offered high-quality evidence and level I evidence as it was a randomized controlled trial. As such, the strategies used in this research can be used to inform practice change and drive the same change.

Similarly, Schapira et al. (2022) also focused on the geriatric population, where they managed to use an interdisciplinary care approach to improve various care outcomes. For instance, the use of this approach led to a substantial reduction in hospital readmissions and emergency room visits among frail elderly adults, hence highlighting the importance of training the medical personnel to offer the needed or required care.

In another source of evidence, Spies et al. (2023) also conducted a study to explore the effectiveness of a program run by trained medical personnel. The intervention was based on a telehealth program to improve process quality. Therefore, medical personnel were offered adequate training to offer care efforts that would enhance the patient’s ability to access care. As such, upon the use of the intervention, the researchers noted that the patients had improved quality indicators, especially those connected to delirium. The patients were capable of weaning from ventilation faster and engaged in earlier mobilization. As such, this is another piece of evidence that can be used to trigger practice change as appropriate.

This study is similar to the study conducted by Yan et al. (2022), which also focused on quality of life as part of the major aims. The study was conducted with the aim of exploring the impact made by a trained multidisciplinary team in the management of cardiovascular hospitalizations and quality of life among patients hospitalized with atrial fibrillation. Upon the use of the intervention, the researchers observed that the patients randomized into the intervention group reported fewer cases of cardiovascular hospitalizations. In addition, the patients also showed a general improvement in their quality of life which also underlined the importance of the trained multidisciplinary team composed of various medical personnel.

As opposed to all the evidence synthesized so far,  the evidence reported by Lewis et al. (2019) is level II evidence, though it offers high-quality evidence as it is a systematic review. This source focused on training done to nurses using simulation methods to help them be more competent in offering patient care services. The sources showed that the trained nurses were able to help the patient have better clinical patient safety outcomes. In addition, the patients showed improvement in the symptoms related to respiratory failure, which further showed the importance of the trained medical personnel. Some of the reviewed sources also showed improvement in terms of reduced cases of the development of pressure ulcers. In terms of similarity of evidence, this evidence source dealt with various care outcomes similar to the findings of Schapira et al. (2022) and Liu et al.(2023), which both focused on the readmission rates among patients upon the use of patient care services offered by trained medical personnel.

According to the evidence provided by Cheung et al. (2021), training medical personnel on various aspects, such as communication skills, can go a long way toward promoting interdisciplinary collaboration among medical personnel to help advance care planning and care outcomes in palliative care among patients on dialysis. Therefore, this study focused on exploring the impact of using trained nurses and social workers to offer the needed care to this patient population. It is worth noting that, according to this source, training the medical personnel led to improvements in various aspects, such as improved empathetic behaviors, effective response to the end of life, and emotional concerns, which all played a critical role in improving patient outcomes.

The approach and findings are also corroborated by another study conducted by Strauven et al. (2019), which also focused on improving patient outcomes related to the offered prescription. Therefore, as part of this research effort, the medical personnel was trained on various aspects of patient care to deliver multifaceted interventions focusing on improving prescriptions. Therefore, upon using this approach, the patients showed improved outcomes and reported better life quality. It is evident that the synthesized evidence was all relevant to the research question. Every single source showed that training the medical personnel involved in the patient care aspects was key to the improvement of patient outcomes.

The Evidence Appraisal

As part of the critical assessment, it is important to review the quality appraisal of the individual pieces of evidence and integrate consistencies in the findings. In addition, it is important to evaluate the meaning and relevance of the findings. Therefore, a total of ten articles were reviewed during the literature review exercise. Out of the ten articles, eight of them were randomized controlled trials, while the two remaining ones were a systematic review and a source that applied a mixed study approach. Therefore, it is important to note that the majority of the articles were level I evidence as they were randomized controlled trials which are considered a golden standard for evidence and evidence-based practice. The implication is that there is greater confidence in recommending the practice change, which in this case has coming up with modalities to train the medical personnel which can offer appropriate patient care practices to reduce the rates of hospital readmissions and reduce the incidences of emergency room visits.

As earlier indicated, all the articles were either level I or II. In addition, in terms of quality, the sources reviewed were also of high quality since they were consistent and generalizable results. In addition, all of the articles had a sufficient sample size for the study design, except for one article authored by Jeon et al.(2020), which considered only eighteen participants. The reviewed articles also had consistent recommendations, basing their recommendations on a comprehensive literature review, including appropriate references to scientific evidence. For example, Schapira et al. (2022) recommended that their intervention be tried or used in institutions that use standards of usual care since their intervention show effectiveness even in environments with no standards of care. The reviewed articles also had definitive conclusions which stated the general findings and potential implications for practice. In all the cases, the conclusions are in line with the research question, which further shows the quality and credibility of the sources used.

The reviewed literature also presented notable consistency in the findings. For example, all the sources reported the importance of training medical personnel to offer better patient care in various settings. The consistency observed in the findings reported by these sources is an indication that these sources can be used to appropriately inform a change in practice. The absence of levels III, IV, and V is also an indication that the proposed practice change should be accomplished as the levels I and II presented are considered the best and the highest levels of evidence.

Even though the findings had so many consistencies, there were also inconsistencies noted, which should be taken into consideration when using the evidence presented to inform a practice change. For example, the sources presented greatly varied training strategies, with others reporting simulation-based strategies while others reported traditional types of training such as following various protocols to train the medical personnel or communication. Therefore, as part of the recommendation, the training methods which produce the best outcomes should be adopted in training the medical personnel to help offer the needed care.

Conclusion

There is a need to continuously train medical personnel regarding various care aspects to help them offer the level of care needed to improve patient outcomes, carry out patient-centered care, reduce cases of emergency department visits and reduce the cases of hospital readmissions. The synthesized evidence shows that a practice change can be successful since the majority of the evidence are level I. In addition, the evidence presented in these articles is also of high quality.

References

Cheung, K. L., Schell, J. O., Rubin, A., Hoops, J., Gilmartin, B. J., & Cohen, R. A. (2021). Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis. Nephrology Nursing Journal, 48(6). https://europepmc.org/article/pmc/pmc9936385

Fortin, M., Stewart, M., Ngangue, P., Almirall, J., Bélanger, M., Brown, J. B., … & Zwarenstein, M. (2021). Scaling up patient-centered interdisciplinary care for multimorbidity: a pragmatic mixed-methods randomized controlled trial. The Annals of Family Medicine, 19(2), 126-134. https://doi.org/10.1370/afm.2650

Jeon, Y. H., Krein, L., Simpson, J. M., Szanton, S. L., Clemson, L., Naismith, S. L., … & Brodaty, H. (2020). Feasibility and potential effects of interdisciplinary home-based reablement program (I-HARP) for people with cognitive and functional decline: a pilot trial. Aging & Mental Health, 24(11), 1916-1925. Doi: 10.1080/13607863.2019.1642298

Lewis, K. A., Ricks, T. N., Rowin, A., Ndlovu, C., Goldstein, L., & McElvogue, C. (2019). Does simulation training for acute care nurses improve patient safety outcomes: a systematic review to inform evidence‐based practice. Worldviews on Evidence‐Based Nursing, 16(5), 389-396. https://doi.org/10.1111/wvn.12396

Liu, X., Song, L., Xiao, S., & Wang, Y. (2023). Comprehensive Geriatric Assessment, Multidisciplinary Treatment, and Nurse-Guided Transitional Care in Hospitalized Older Adults: A Randomized Controlled Trial. Research in Gerontological Nursing, 1-7. https://doi.org/10.3928/19404921-20230606-03

Schapira, M., Outumuro, M. B., Giber, F., Pino, C., Mattiussi, M., Montero-Odasso, M., … & Perman, G. (2022). Geriatric co-management and interdisciplinary transitional care reduced hospital readmissions in frail older patients in Argentina: results from a randomized controlled trial. Aging Clinical and Experimental Research, 34(1), 85-93. Doi: 10.1007/s40520-021-01893-0

Spies, C. D., Paul, N., Adrion, C., Berger, E., Busse, R., Kraufmann, B., … & Weiss, B. (2023). Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial. Intensive Care Medicine, 49(2), 191-204. Doi: 10.1007/s00134-022-06949-x

Strauven, G., Anrys, P., Vandael, E., Henrard, S., De Lepeleire, J., Spinewine, A., & Foulon, V. (2019). Cluster-controlled trial of an intervention to improve prescribing in nursing homes study. Journal of the American Medical Directors Association, 20(11), 1404-1411. https://doi.org/10.1016/j.jamda.2019.06.006

Uslu-Sahan, F., & Terzioglu, F. (2020). Interprofessional simulation-based training in gynecologic oncology palliative care for students in the healthcare profession: A comparative randomized controlled trial. Nurse Education Today, 95, 104588. https://doi.org/10.1016/j.nedt.2020.104588

Xu, L., & Wenhu, L. (2021). Medical personnel training mode of “teacher leading apprentice” through “team based” medical aid to Tibet. Medical Education Management, 7(2), 133. https://doi.org/10.3969/j.issn.2096-045X.2021.02.006

Yan, H., Du, Y. X., Wu, F. Q., Lu, X. Y., Chen, R. M., & Zhang, Y. (2022). Effects of nurse-led multidisciplinary team management on cardiovascular hospitalization and quality of life in patients with atrial fibrillation: Randomized controlled trial. International Journal of Nursing Studies, 127, 104159. https://doi.org/10.1016/j.ijnurstu.2021.10415.